| NPI | 1053744656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: 139371) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 139371) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2026-03-12 |